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M1291 Pt 66+ frailty and medial dem

M Codes

Also known as: frail elderly with dementia, senior cognitive decline, geriatric frailty

Patient age 66 and older with documented frailty and memory loss or dementia. Documents elderly patients with cognitive impairment and functional decline.

In Plain Language

elderly with memory problems; frail senior with confusion

Clinical Context

Used in geriatric quality measures to identify high-risk older adults with combined frailty and cognitive decline requiring specialized management and palliative care considerations.

RVU Information

CPT M1291 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.

Billing & Documentation

M-codes cover quality measures and performance reporting. They are used in value-based care programs to track whether specific clinical actions were taken. Documentation must support that the measured action was performed or a valid exclusion applies.

Specialties

GeriatricsNeurologyInternal Medicine

Frequently Asked Questions

What is CPT code M1291?

CPT M1291 (Pt 66+ frailty and medial dem) is a M Codes code. Patient age 66 and older with documented frailty and memory loss or dementia. Documents elderly patients with cognitive impairment and functional decline.

Is M1291 covered by insurance?

M1291 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Used in geriatric quality measures to identify high-risk older adults with combined frailty and cognitive decline requiring specialized management and palliative care considerations.

When is CPT M1291 used?

Used in geriatric quality measures to identify high-risk older adults with combined frailty and cognitive decline requiring specialized management and palliative care considerations.

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.